Home award Nomination Form

Nomination Form

Vigil India Movement – Bangalore

M.A. THOMAS NATIONAL HUMAN RIGHTS AWARD 2016

Nomination Form

Nominee:
Name			Sex
Age / Date of Birth
Address
Telephone			Email
Please state the organization (if any) to which the nominee is affiliated and the nominee’s position in the organization
Name of the Organization
Address
Web address			Email
Reasons for nomination (to be written in a separate sheet) Ø Please justify your nomination by describing clearly the nominee’s contribution towards the protection and promotion of human rights in India. Enumerate the activities, achievements and impact on society or state policy. Ø Please include a brief resume of the nominee. Ø Please attach any reference material in connection with the above that you may have.
Nominator
Name		Profession
Address
Telephone		Email
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